Honor Systems and Open World Activities in Red Dead Redemption II: Impact on Players with Symptoms of Anxiety and Depression

Defense Slides

KadaganchiA_ThesisIII_MockDefense_March 07.pdf


This research delves into the profound impact of honor systems and open-world activities on players' mental well-being within the immersive world of Red Dead Redemption II (2018). The study uncovers intricate connections between gameplay choices, playstyles, and psychological needs satisfaction using self-determination theory (SDT), shedding light on the well-being effects for players experiencing phases of low mood. Operationalized measures were employed to assess pre-game self-reported anxiety and depression symptoms, engagement within honor and open-world activities, and post-engagement mental well-being. Data was sourced through an online questionnaire (n = 210) and meticulously analyzed to unveil insights into the engagement and playstyles adopted to alleviate players’ symptoms of anxiety and depression. The study's findings contribute valuable knowledge to the expanding research on video games and their impact on mental health, advocating for game development that harnesses these interactive media’s positive influence on players' well-being.

Postionality Statement

As a master’s student in game development, I specialize in video game production and project leadership with a sub-specialization in level design. A diverse set of experiences has shaped my academic journey. My undergraduate studies were in civil engineering, and then I worked in business analytics and management for four years. Throughout this, a persistent desire remained within me to find a way to merge my passion for video games and professional expertise.


The onset of the COVID-19 pandemic and the subsequent lockdowns and restrictions took a toll on my mental well-being. While I am not a mental health professional, nor was I in any treatment, it was during these times that I rediscovered my long-lost love for video games. Playing Red Dead Redemption II provided a much-needed respite, significantly improving my mental state. This personal journey, marked by the transformative power of video games, led me to choose this thesis research. My commitment to this research stems from a deep understanding - recognizing video games' potential to impact individuals, especially during challenging times, positively.


In 2019, 970 million people lived with a mental disorder, one in every eight people (WHO, 2022). The pandemic has affected the public’s mental health and well-being in various ways, including isolation and loneliness, job loss, financial instability, illness, and grief (Panchal et al., 2023). According to Panchal et al.’s survey (2023), starting this decade, concerns about mental health remain elevated three years after the onset of the COVID-19 pandemic, with 90% of U.S. adults believing that the country is facing a mental health crisis. Among the disorders, anxiety and depression are the most common (WHO, 2022). Symptoms of anxiety and depression increased during the pandemic and are more pronounced among young adults and women (Panchal et al., 2023). Interestingly, the pandemic has accelerated the digital evolution of mental health service delivery, with a particular focus on unconventional approaches to alleviate anxiety and depression symptoms (Ruiz et al., 2022). With geographical and economic concerns and stigma associated with psychotherapy, new technologies and video games can overcome these challenges as therapy as they offer interactive entertainment (Ruiz et al., 2022).

Video Games are now a prevalent and profitable leisure activity (Johannes, 2021). The revenues of the games industry are more significant than those of the film industry (Richter, 2022), and the number of people who report playing games has never been higher, with around 3.1 billion gamers currently in the world (Books, Movies, Music, Games - Worldwide, n.d.). According to a survey by the ESA, the top reasons to play video games are far more than entertainment, with 58% of the respondents agreeing to play video games for stress relief/ relaxation and 61% reporting that it makes them feel less anxious (Kodiak, 2023). Over 50% of players affirm that video games assist them during challenging periods, 63% bring them joy, and 52% assert that it aids them in overcoming difficulties (Kodiak, 2023).

This thesis explores the potential of video games to have varying effects on players with different playstyle approaches to systems that reward players for performing helpful deeds with non-player characters (NPCs). For this, the critically acclaimed Red Dead Redemption II has been chosen, a 2018 action-adventure game developed and published by Rockstar Games (RDR2, 2018), which sold more than 57 million copies worldwide as of November 2023 (Clement, 2023). Set in a fictionalized representation of the United States in 1899, the story follows the outlaw Arthur Morgan, who must survive the decline of the Wild West against government forces and other adversaries (RDR2, 2018). Players can witness or partake in random events and are rewarded for helping strangers along with many side activities like hunting and other board games (RDR2, 2018). The honor system measures how the player’s actions are perceived: morally positive deeds increase honor, while acts like theft and harming innocents decrease it. Dialogue and outcomes differ based on honor level and provide unique in-game benefits (RDR2, 2018).

The research questions were.

1.               How do individuals experiencing anxiety or depression symptoms interact with game systems that necessitate making honorable choices and open-world unstructured activities in Red Dead Redemption II?

2.               To what extent do players' engagement with game systems necessitating honorable choices and open-world unstructured activities in Red Dead Redemption II influence their overall mental well-being?

Background Literature

Video Games contain fun and are believed to have many cognitive, motivational, and social advantages associated with gameplay (Granic et al., 2014). They are a means for developing problem-solving skills, enhanced creativity, and a suite of cognitive functions (Granic et al., 2014). Video game designers can immerse individuals in virtual worlds, motivating them to pursue meaningful objectives while sustaining engagement through timely feedback and consistent rewards (Granic et al., 2014). Video game play may be the most efficient and effective way for youth to generate positive feelings through the “flow” phenomenon (Granic et al., 2014). A positive emotional experience, when immersed in an intrinsically rewarding activity that elicits a high sense of control and loss of self-consciousness (Granic et al., 2014), and everything else becomes oblivious to the player (Laffan et al., 2016). Flow experiences have repeatedly been linked to positive outcomes, leading to similar real-world results (Granic et al., 2014). Players also acquire prosocial skills when playing games designed to reward practical cooperation, support, and helping behaviors (Granic et al., 2014).

Video games are also deemed therapeutic tools with advantages that include affordability, accessibility, and the ability to engage a broad audience (Hazel et al., 2022). 89% of the participants in Hazel et al.’s (2022) study acknowledged experiencing psychological or emotional benefits from video games - those who perceived benefits reported higher psychological well-being scores across flow state and self-determination metrics: competence, autonomy, and relatedness. Psychological benefits differed by genre, with role-playing games (RPGs) scoring highly among all participants (Hazel et al., 2022), informing the choice of genre for therapeutic benefits.

RPGs focus heavily on building a character’s persona and navigating them through a rich narrative, allowing them to portray complex emotions (Mahood & Hanus, 2017). Exposure to these portrayals of such emotions can carry over to the emotional state of the player (Mahood & Hanus, 2017). With the help of “transportation theory,” a convergent process where all mental systems become focused on the narrative, causing the outside world to receive only secondary mental processing. This causes the individuals to experience significant emotional reactions (Mahood & Hanus, 2017).

Pilot studies on web-based RPGs, known as "serious games," have shown promise in enhancing the mental health of specific target groups. Coulter et al. (2019) studied their use to support bullied and victimized sexual and gender minority youth, while Yokomitsu et al. (2020) utilized SPARX, a mobile RPG game for university students in Japan. Additionally, Lee et al. (2014) explored a CRPG titled Journey to the West for stress management among Asian foreign college students. Commercial off-the-shelf video games (COTS) have also shown potential applications for improving mental health and reducing stress and anxiety (Pallavicini et al., 2021). COTS has several advantages over “serious games,” including their low cost, ready-to-use format, advanced graphic quality, and the ability to reach millions of players (Pallavicini et al., 2021). COTS was found to help diminish stress and improve cognition and relaxation in players of all ages, from healthy individuals to patients who have post-traumatic stress disorder, comorbid anxiety, etc. (Pallavicini et al., 2021).

Beyond academic research, many players have shared online testimonials about the transformative power of narrative-driven COTS during challenging life circumstances. Players have expressed how Naughty Dog's The Last Of Us, globally praised for its innovative storytelling, positively influenced their personal growth, calling it a healing experience during times of crippling anxiety (Taylor, 2022). Players on Reddit have also shared their experiences with Red Dead Redemption II, claiming that it saved them from anxiety, helping them wind down, work through the losses of loved ones (Lewis, 2022), and even conquer breakups (Onder, 2019).

Anxiety, characterized by feelings of tension, intrusive worried thoughts, and increased blood pressure, affects individuals in various forms (Borwin et al., 2022). Phobias impact approximately 10.3% of patients, followed by panic disorder (6%), social anxiety disorder (2.7%), and generalized anxiety disorder (2.2%) (Borwin et al., 2022). While mild symptoms may not necessitate immediate treatment, those experiencing marked distress warrant intervention (Borwin et al., 2022). Meaningful interactions and gaming-related activities within social simulation games like Animal Crossing: New Horizons had significant positive associations with increased loneliness and anxiety due to lawfully enforced lockdowns during the Pandemic (Lewis et al., 2021).

On the other hand, Depression is an incapacitating mental disorder affecting approximately 16% of the population (Duval et al., 2006). Clinical predictors often comprise persistent low mood, feelings of guilt, changes in appetite, and disturbances in sleep patterns, with up to 15% of severely depressed patients at risk of suicide (Duval et al., 2006). Using the 3D video game Super Mario Odyssey over six weeks has successfully decreased rumination and reduced depression symptoms, according to Bergmann et al.’s (2023) study. Similar research over a longer duration on video games Journey compared to Flower, both developed by Thatgamecompany, and treatment as usual control group proved to have shown increased intrinsic motivation, decreased sensitivity to rejection, and an increase in hope and optimism among the test groups (Lichtwarck-Aschoff et al., 2021).

Understanding the motivational factors underlying such experiences is essential, and the Self Determination Theory (SDT) developed by Deci and Ryan (2000) offers a valuable framework for exploring the said psychological needs fulfillment and benefits by video game engagement and motivation to play.


Self-Determination Theory in Video Games

Video games are significant motivators when players experience autonomy, competence, and relatedness during gameplay (Ryan et al., 2006). SDT, an established theory of motivation (Deci & Ryan, 2000), examines how essential psychological needs satisfaction contributes to player motivation and psychological well-being—key factors SDT addresses: autonomy, competence, and relatedness (Ryan et al., 2006).

Autonomy pertains to the sense of willingness when undertaking a task; high perceived autonomy arises when activities are pursued for personal interest and volition. Game designs that offer flexibility, choices, and rewards were posited to enhance autonomy (Ryan et al., 2006). Competence involves the need for challenge and a sense of effectiveness and is augmented by acquiring new skills, facing optimal challenges, and receiving positive feedback (Ryan et al., 2006). Relatedness is experienced when individuals feel connected with other players in multiplayer games (Ryan et al., 2006). Players are also likely to experience relatedness in single-player RPG games when game characters model as social characters within the player’s mind, and role-play includes participating in dyadic social interactions with them (Katelyn et al., 2022). Relatedness needs can be met with three distinct levels of imaginative engagement: recognition, where players are presented with legible and consistent information about the character's alignment; players are given the character’s subjectivity to interact; and allegiance, where players are led to root for or against characters on their moral evaluation (Katelyn et al., 2022).

Deci and Ryan (2000) assert that well-being is intricately connected to satisfying psychological needs, motivating continued play, and enhancing psychological well-being. Following this, the rationale for selecting RDR2 becomes apparent. The game offers a rich, open-world environment with intricate narrative-driven gameplay and dynamic honor systems presenting the player with moral choices and consequences (Favis, 2018) by applying SDT to analyze the player’s engagement with the honor system and open-world activities to investigate differences if any between the two gameplay elements and systems influence players’ levels of anxiety and depression.

Deconstruction of Red Dead Redemption II

Red Dead Redemption II (2018) (RDR2) is an open-world, action-adventure shooter set in the American West and South period of decline circa 1899 (RDR2, 2018). In the main storyline, players assume control over Arthur Morgan, a hero of the Wild West (RDR2, 2018). A critical piece in reaching an apex vulnerability as the narrative progresses is the game’s honor system that continuously scores the choices and actions that the player assumes in Arthur's role.

The honor system assesses players' actions and exhibits suitable icons for every effort. For every honorable activity, a white Arthur icon appears on the right, accompanied by positive audio feedback that reinforces the virtuous nature of the deed (Moser, 2022). Conversely, dishonorable acts trigger a red Arthur icon with a skull symbol and an unpleasant “ding” audio cue (Moser, 2022).

Actions and their impacts on honor (Editorial Team, 2023).

Actions such as defending stagecoaches against bandits, completing gang hideouts, capturing bounties, disarming opponents in duels, or aiding strangers in random encounters contribute to substantial honor gains (RDR2, 2018). Contextual variations like helping or saving story characters in distress, aiding them in quests, and completing story missions with a moral resolution all contribute to honor gain (RDR2, 2018). Donating to charitable causes, performing chores to help the gang with food or money, and intervening in conflicts gain honor (RDR2, 2018). Serving jail time, surrendering to the law, and paying off bounties for unlawful activities also increase honor (RDR2, 2018).


Conversely, engaging in criminal activities such as killing or robbing innocent civilians and looting corpses deceased before the player’s arrival results in very high honor losses (RDR2, 2018). Animal cruelty, stealing horses, and refusing to help story characters incur honor losses (RDR2, 2018).


Players can monitor their honor level through a sliding scale at the press of a button. A neutral playstyle will keep the player's honor level at zero, which is considered negative. The honor scale ranges from -320 to +320 points, divided into 16 ranks (Thorn, 2022) from -8 to +8, divided by 40 points each. Positive honor grants discounts in shops (50% at +7, 25% at +5), new outfits, and increased drop rates for valuable consumables and jewelry while looting bodies (Thorn, 2022). Similar benefits apply to a -1-honor rank, with a higher loot drop rate from dead bodies but no additional benefits for lower honor ranks (Thorn, 2022).

Additionally, NPCs who have received help from the player or have been affected by the player in earlier sections make eventual appearances in later stages to confront them. From grateful NPCs gifting an item from the stores to cursing them about how they have been affected (RDR2, 2018). Alongside the spontaneous open-world activities, time-sensitive stranger and story character missions are closely integrated into the game's narrative for optional honor.

Optional Honor Missions

The player can partake in or opt out of optional honor missions, earning significant honor points upon completion (RDR2, 2018). Arthur is requested to help many side characters within the game, from his ex-fiancé to rescue his brother and father (RDR2, 2018) to a series of loan sharking missions to collect debts for Leopold Strauss. However, as the narrative progresses, he grapples with tuberculosis, prompting him to absolve or assist the debtors in return (RDR2, 2018). Arthur also assists story characters affected by him in earlier chapters, unlocking new captivating cutscenes, providing supplementary storylines, and portraying the player as empathetic and endearing at a high honor level (RDR2, 2018).

Ways honor level affects the main story of the game.

The honor level subtly influences Arthur's personality and behavior. Pursuing high honor exhibits heightened compassion and selflessness, with a concern for the gang members (Metz, 2023). Low honor is characterized by selfishness and callousness. Arthur's perspectives differ significantly based on his honor level. The low-honor version's atmosphere is dark and somber with unsettling music, while the high-honor version features soft, hazy light and heartfelt reflections (Metz, 2023). Additionally, Arthur encounters two distinct spirit animals based on his honor level: a coyote as a constant companion and a deer as a guiding presence (Metz, 2023).

Story NPCs' reactions to a dishonorable Arthur also vary. They find him confusing at low honor, but honorable Arthur is deemed the best they have known (Metz, 2023). Arthur’s end also differs based on his honor level. Dishonorable Arthur is shot in the face or stabbed in the back, while an honorable Arthur succumbs to his illness and wounds. His grave is weathered and reads, "Blessed are those that mourn for they are comforted,” with low honor. The high honor tombstone is adorned with flowers and inscribed, "Blessed are those who hunger and thirst for righteousness" (Metz, 2023). These variations based on the honor system highlight the nuanced impact of the honor choices within the narrative, as explored in this thesis.

Prosocial Behavior and How it Affects Anxiety and Depression in Individuals.

Empathy, the ability to understand and share the emotional experiences of others, is crucial for moral development and prosocial behavior (Knight et al., 2019). Prosocial activities positively affect emotional well-being, eudemonic well-being, happiness, and the absence of negative emotions (Miles et al., 2021). People find meaning when their actions are right and justified, leading to a sense of belonging and positive social connections (Miles et al., 2021) when they help a stranger, acquaintance, or friend (Schacter & Margolin, 2019). Brown et al. (2003) state that helping others increases positive emotion, which speeds up cardiovascular recovery from negative emotions.

Emotions like anger and sadness influence decision-making preferences (Xiao et al., 2021). Individuals experiencing sadness tend to spend more time helping others than any other feeling (Xiao et al., 2021). Depressed individuals, often lacking self-worth and social competence, find positive rewards in prosocial behaviors, promoting resilience and reinstating their sense of purpose and belonging (Schacter & Margolin, 2019). The most vital links between prosocial behavior and positive mood were found in individuals experiencing elevated depression symptoms (Schacter & Margolin, 2019). Increased anxiety is linked to heightened empathy due to worry, concern for others, and the effect of one’s actions (Knight et al., 2019). Prosocial acts have also been linked to reduced social avoidance, suggesting they can alleviate anxiety (Miles et al., 2021).

The enhanced well-being from prosocial behaviors can also be explained by self-determination theory (Martela & Ryan, 2015). Prosocial behavior fosters competence needs by demonstrating involvement and usefulness (Weinstein & Ryan, 2010). Helping is inherently interpersonal and thus impacts relatedness by directly promoting closeness to others (Weinstein & Ryan, 2010). Prosocial actions that are freely done are expressions of well-internalized values to experience autonomy satisfaction and the positive states that follow from the behavior (Weinstein & Ryan, 2010).


Moral activation and disengagement mechanisms


Players engage in morally reprehensible behavior within video games, especially RPGs, regardless of their moral compass in real-world contexts. Bandura and Cervone's (1986) framework for moral disengagement sheds light on the motivations behind such actions in the real or virtual worlds. These include reconfiguring actions for morally acceptable purposes, keeping a distance from the act, attributing blame to victims, and dehumanization (Bandura & Cervone, 1986). Klimmt et al. (2008) add a ninth mechanism, highlighting players' ability to absolve themselves from negative feelings by reminding themselves that their actions are virtual and no actual damage was done, minimizing their impact on real-life consequences.

Open world activities in Red Dead Redemption II

When the player is free to roam at their will outside a story or side mission, RDR2 offers many activities categorized into unstructured gameplay tailored for relaxation, mimicking real-life unwinding activities, and those requiring violence and challenging the player (RDR2, 2018). As delineated in this thesis, relaxation is a wide array of activities. Fishing is where players can enjoy the tranquility of nature while seeking out fifteen species of fish with legendary counterparts (RDR2, 2018). Horse riding and breaking wild horses provide another calming pursuit, allowing players to bond with 21 horse breeds across the map (RDR2, 2018). Free roaming enables exploration of the game’s vast environment, populated with diverse characters, providing immersive experiences and discovering the game’s captivating soundtrack (RDR2, 2018). Attending shows and plays provides a laid-back experience (RDR2, 2018). Passing the time with NPCs in small games like Dominoes, Blackjack, Five Finger Fillet, etc. (RDR2, 2018). Players can often customize Arthur’s outfits from head to toe and maintain their weapons and mounts (RDR2, 2018).

Criminal and violent activities like bounty hunting are lucrative methods of making money by tracking bounties and bringing them in for a reward (RDR2, 2018). Over 100 species and 16 legendary animals can be hunted for their pelt, horns used for crafting upgrades, or sold for cash (RDR2, 2018). Criminal activities include robbing banks, homesteads, businesses, and trains, garnering much attention, and bounty hunters if not careful (RDR2, 2018), leading to significant challenges.

Players can engage in this unstructured gameplay, creating a high sense of autonomy in their choices to catch a break and unwind in the open world (Hughes, 2023). As explored in this thesis, the nature of the activity is perceived to have varying engagement based on the player’s pre-engagement symptoms.

Methodology and Data Collection

A 120-question online survey was created on Qualtrics that included measuring the levels of anxiety and depression, the gameplay players have engaged in RDR2, and the post-play wellbeing using SDT and wellbeing measures. The questionnaire was designed on the following list of hypotheses based on the research questions this thesis aimed to find an answer to.

·   Hypothesis 1: Increased self-reported anxiety or depression levels among players will be positively associated with heightened engagement in activities involving making honorable choices in RDR2.

·   Hypothesis 2: Increased self-reported anxiety and depression levels among players will be positively associated with increased engagement in relaxing and open-world pastime activities in RDR2.

·   Hypothesis 3: A positive correlation exists between players who exhibit higher engagement in honorable activities within the game and elevated levels of self-reported mental well-being resulting from their gameplay experience.

·   Hypothesis 4: A positive correlation exists between players who exhibit higher engagement in open-world relaxation pastime activities within the game and elevated levels of self-reported mental well-being resulting from their gameplay experience.

·   Hypothesis 5: A positive correlation exists between players' involvement in moral decision-making within video games and their self-reported basic psychological needs scores in SDT.

·       Hypothesis 6: A positive correlation exists between players' involvement in open-world relaxation activities within video games and their self-reported basic psychological needs scores in SDT.

Data was collected anonymously through online survey links distributed across various subreddits frequented by RDR2 players, such as r/reddeadredemption, r/reddeadredemption2, etc. The survey was also shared in subreddits of other popular games to ensure a diverse sample. Participants were required to acknowledge a consent form outlining the research's purpose, their rights, and associated risks, with no compensation provided. Additionally, anonymous links were shared among friends and family for further distribution.


The survey had four sections: Cronbach’s alpha was run for existing reliable scales and not for the qualitative sections related to gameplay.

·   Section 1 (Q1-29) collected data on gaming timelines, RDR2 hours, and factors affecting pre-existing low mood, utilizing the GDS-15 for depressive levels and the GAD-7 scale for anxiety levels.

o   Geriatric Depression Scale (GDS) (α = 0.933)

o   Generalized Anxiety Disorder =7 (GAD-7) (α = 0.8838)

·   Section 2 (Q30-54) involved qualitative inquiries into RDR2's honor systems engagement.

·   Section 3 (Q55-66) explored engagement in open-world activities within RDR2.

·   Section 4 (Q 67- 116) assessed participants' perceived effects from RDR2, utilizing the Basic Psychological Needs Scale (BPNS), followed by 14 items from the WEMWBS.

o   Basic Psychological Needs Scale

§  Autonomy subscale (α = 0.7526)

§  Competence subscale (α = 0.7148)

§  Relatedness subscale (α = 0.7950)

o   Warwick Edinburgh Mental Wellbeing Scale (WEBMWBS) (α = 0.92)


Two hundred and ten respondents (N = 210) over 18 completed the survey, giving a confidence interval of 99% with a 9% margin of error or a 95% confidence interval with a 7% margin of error. Of the respondents, 9% experienced pandemic-related anxiety, 7% had pandemic-related depression, 8% underwent loss of loved ones, 16% and 21% faced academic and work-related stresses, 12% faced relationship challenges, and 25% stated other reasons for low mood.

A Z-score threshold of -0.5 and +0.5 was applied to delineate GAD-7, GDS, and WEMWBS and responses on all scales into high, medium, and low categories. The area between one-half standard deviation below and above the mean covers 38% of the data under the normal curve, providing an almost equal data distribution between the categories.

Hypothesis 1a (Rejected): Increased self-reported anxiety levels among players will be positively associated with heightened engagement in making honorable choices in RDR2.

ANOVA revealed no statistical significance between the independent variable, self-reported pre-game anxiety levels (GAD), and the dependent interval variable engagement in honor activities (p-value = 0.2096), rejecting the hypothesis.

Hypothesis 1b (Accepted): Increased self-reported levels of depression in players will be positively associated with increased engagement in making honorable choices in RDR2.

ANOVA revealed a moderately significant relationship between the independent variable, self-reported depression levels (GDS), and the dependent interval variable, players' honor level (p-value = 0.0106*). Upon analysis, players with low depression levels had a mean engagement of 88.478 in honorable choices, while those with medium depression levels scored 92.280, and those with high depression levels scored 96.680. These results indicate a positive relationship, validating the hypothesis.

Hypothesis 2a (Rejected): Increased self-reported anxiety levels among players will be positively associated with increased engagement in open-world pastime activities in RDR2.

ANOVA analysis indicated a moderately significant association between the independent variable, self-reported anxiety levels (GAD), and the dependent variable, players' engagement with open-world pastime activities (p-value = 0.0187**). Upon analysis, players with low self-reported anxiety levels had a mean engagement of 42.507 in pastime activities. In contrast, those with medium anxiety scored 38.683, and high anxiety levels scored 39.870, providing an observation that needs to be further examined between different styles of open-world gameplay activities.

Post-hoc analysis splitting the open-world activities into activities tailored for relaxation and others that require violence gave rise to interesting findings. Players with self-reported anxiety symptoms showed a higher significant relationship (p-value = 0.0387**) between relaxing activities and violent ones (p-value = 0.0586*). Deep dives into mean values of the engagement within each category also showed increasing engagement in both types of activities with increasing anxiety symptoms, further confirming the hypothesis.

Hypothesis 2b (Accepted): Increased self-reported levels of depression in players will be positively associated with increased engagement in relaxing and open-world pastime activities in RDR2.

ANOVA revealed a moderately significant association between self-reported depression levels (GDS) and players' engagement in open-world pastime activities (p-value = 0.0831*). Upon analysis, players with low depression levels had a mean engagement of 42.028, players with medium depression levels scored 39.756, and players with high depression levels scored 38.894. This suggests a notable negative correlation, which needs further examination between different open-world gameplay activity styles.

Post-hoc analysis, dividing open-world activities into relaxation-oriented and violent ones, revealed similar interesting findings. Players with self-reported depression symptoms showed a significantly higher relationship (p-value = 0.0094***) with relaxation activities compared to violent ones (p-value = 0.0709*), indicating a stronger preference for relaxation activities. Additionally, mean engagement increased in both types of activities with higher depression symptoms, further strengthening the hypothesis.

Hypothesis 3 (Rejected): A positive correlation exists between players who exhibit higher engagement in honorable activities within RDR2 and elevated levels of self-reported mental well-being resulting from their gameplay experience.

Chi-squared analysis revealed no significant relationship between the independent variable engagement in honorable choices and dependent variable WEB categories (p-value = 0.186), rejecting the hypothesis.

Hypothesis 5 (Rejected): There is a positive correlation between players' involvement in moral decision-making within RDR2 and their self-reported basic psychological needs scores in SDT.

5a: Chi-squared analysis indicated an insignificant relationship between the independent variable engagement in honorable choices and the dependent variable competence sub-scale categories of the BPNS (p-value = 0.226), rejecting the hypothesis.

5b: Chi-squared analysis indicated an insignificant relationship between the independent variable engagement in honorable choices and the dependent variable relatedness sub-scale categories of the BPNS (p-value = 0.448), rejecting the hypothesis.

5c: Chi-squared analysis indicated an insignificant relationship between the independent variable engagement in honorable choices and the dependent variable autonomy sub-scale categories of the BPNS (p-value = 0.400), rejecting the hypothesis.

Hypothesis 4 (Accepted): A positive correlation exists between players who exhibit higher engagement in open-world relaxation pastime activities within RDR2 and elevated levels of self-reported mental well-being resulting from their gameplay experience.

Chi-squared analysis showed a very significant relationship between the independent variable engagement in open-world pastime activities and the dependent variable WEB categories (p-value = 0.000***) accepting the hypothesis.

Hypothesis 6 (Accepted): There is a positive correlation between players' involvement in open-world relaxation activities within RDR2 and their self-reported basic psychological needs scores in SDT.

6a: Chi-squared analysis revealed a very significant relationship between the independent variable engagement in open-world pastime activities and the dependent variable competence subscale of the BPNS (p-value = 0.000***) accepting the hypothesis.

6b: Fisher’s exact analysis revealed a very significant relationship between the independent variable engagement in open-world pastime activities and the dependent variable relatedness subscale of the BPNS (exact = 0.000***) accepting the hypothesis.

6c: Chi-squared analysis revealed a very significant relationship between the independent variable engagement in open-world pastime activities and the dependent variable autonomy subscale of the BPNS (p-value = 0.000***) accepting the hypothesis.


For the following thesis, the pre-gameplay assessment of anxiety and depression symptoms associated with their gameplay with honorable choices and unstructured open-world activities have been analyzed and separately discussed. Amongst the studied mental health aspects, limited results associated with honor systems and distinct results in unstructured open-world activities were delineated. Five of the six hypotheses about honorable choices were not significant. Six of the six hypotheses were highly significant for unstructured open-world activities.

Results from Engagement in Honorable Activities (→ positively correlated)


Research Question



Anxiety/depression impact on honor engagement

H1a: Anxiety → Honor Engagement


H1b: Depression → Honor Engagement


Honor engagement impact on mental well-being

H3: Honor engagement → Well-being


H5a: Honor engagement → Competence needs


H5b: Honor engagement → Relatedness needs


H5c: Honor engagement → Autonomy needs



Table 8: Hypotheses on honor systems and their results

Pre-existing anxiety and depression symptoms influence engagement with honor systems.


The global COVID-19 pandemic has significantly impacted the mental health of individuals worldwide, as stated by many studies (Panchal et al., 2023). Against this, the launch of RDR2 in this timeline provided a unique opportunity to explore its potential effects on mental well-being. 27.4% of the survey participants reported engaging with the game during this period, allowing for an examination of various playstyles, prosocial behaviors, and their potential correlations with anxiety levels. Despite the absence of statistically significant findings for honor systems engagement, noteworthy trends and insights emerged from the data.


An insignificant relationship between players’ self-reported anxiety levels and their engagement in honorable activities within RDR2 suggests that players experiencing heightened tension and intrusive and worrisome thoughts did not necessarily demonstrate an inclination toward making honorable choices within RDR2 (H1a). This finding disproved Knight et al.’s (2019) theory that increased anxiety extends to increased empathy followed by increased prosocial behavior. This suggests that prosocial choices in video games cannot necessarily break the recurring patterns of worrisome thinking in player behaviors. Another possible explanation for this outcome could be the increased moral disengagement by the players due to increased anxiety levels of the public during the pandemic-induced lockdowns. This possibility is supported by the findings of a significant increase in moral disengagement to reprehensible conduct by Gori & Topino (2021) during the pandemic concerning increased anxiety, lower well-being, and higher moral disengagement scores. Since 38% of the survey participants played during the timeline (2020 - 2022), it is plausible that heightened anxiety levels in players may have led to increased moral disengagement.


In contrast, the study did find that among players reporting high levels of depression, there was a significantly increased positive engagement in honorable choices (H1b). Players experiencing persistent low mood or guilt demonstrated increased engagement in prosocial behavior with non-player characters within RDR2. Suggests that players deliberately chose to exhibit an honorable playstyle in exchange for a positive experience that could have alleviated self-reported depression. The above results align with Greitemeyer’s (2014) findings that prosocial video gameplay impacts well-being and positive behavior. Depressed individuals often lack self-worth and exhibiting prosocial behavior in real life significantly negates negative emotions reinstating a sense of purpose in them (Schater and Margolin, 2019). This suggests that depressed individuals undergo the same process when they’re given a moral choice of exhibiting prosocial behavior with other NPCs in video games. This finding also confirms Schater and Margolin’s (2019) observation that people experiencing feelings of sadness tend to devote more time to helping others, and the strongest positive effects are seen in those with the highest depression symptoms.


Impact of Honor engagement on mental well-being.

Contrary to expectations, players with high honor playthroughs did not exhibit higher mental well-being scores on the WEB scale than their low honor counterparts (H3). It implies that playstyles, whether high honor or low honor, i.e., adhering to players' moral compass in video games or disengaging during play, may not influence players' enjoyment and well-being benefits derived from it challenging Greitemeyer’s (2014) findings. While prosocial video game play helps regulate negative emotions, it is essential to note that engaging in morally reprehensible conduct may not have significantly diminished effects.

These findings align with Daniel Shafer's (2012) examination of moral choices in violent video games. RPG games are designed to allow players to choose the style of play that influences their overall satisfaction. Shafer's (2012) study reveals that players making morally ambiguous or dishonorable intentions do not experience significantly different levels of enjoyment than those making morally upright choices. In video games, players assume responsibility for their in-game decisions, with satisfaction closely tied to aligning these choices with their moral codes (Shafer, 2022). Individuals who undertake morally disengaged decisions within the game demonstrate an internal justification process, indicating it does not necessarily impact the game's enjoyment (Shafer, 2022). Klimmt’s (2008) ninth moral disengagement mechanism of reminding themselves of virtual actions with no actual damage further bolsters this theory.

Additionally, no significant relationship was found between the satisfaction of needs for competence, autonomy, and relatedness and player engagement in honorable activities. Competence needs may not necessarily be linked to the moral alignment of their in-game actions but with challenges, achievements, and mastery of skills within the game environment (H5a). While playing as high honor gives the players a sense of achieving a peak level of vulnerability and the best possible story outcome in RDR2, the fun and challenge players face in low honor equally satisfies the need for competence. In narrative video games like RDR2, competence needs are also majorly satisfied by progressing through the narrative, completing missions, overcoming obstacles, and unlocking new outfits, but not necessarily through their moral alignment within the game. Some players may perceive exhibiting the most virtuous nature in the game as an avenue to satisfy their competence needs; others may prioritize combat and prowess.


Grasse et al. (2019) state that relatedness needs from RPG games are met in a series of three distinct levels of imaginative engagement with fictional characters. Recognition: when spectators are presented with legible and consistent information regarding the characters. Alignment: when spectators are given access to a character’s subjectivity to facilitate perspective-taking and allegiance in which spectators are led to root for or against characters based on the moral evaluation. While exhibiting a high honor in play, it should ideally satisfy the needs for relatedness higher than moral disengagement due to higher allegiance with the NPC characters. Findings suggest a different interplay with moral nature in video games to relatedness need satisfaction from video games (H5b). Players can choose their character’s honorable or dishonorable choices and as long as the three engagement levels meet to the point that the player feels a level of belonging in the game world, relatedness needs are still met the same for both sides of allegiance (H5c).



Results from engagement in Open-world pastime activities (→ positively correlated)


Research Question



Anxiety/depression impact on open world engagement

H2a: Anxiety → Open world engagement


H2b: Depression → Open world engagement


Open world engagement impact on mental well-being

H4: Open world engagement → Well-being


H6a: Open world engagement → Competence needs


H6b: Open world engagement → Relatedness needs


H6c: Open world engagement → Autonomy needs



Table 9: Hypotheses on open world activities and their results

All six hypotheses concerning engagement in unstructured open-world pastime activities have shown significant validation. Despite H2a and H2b initially displaying slight negative correlations, further post hoc analyses dividing the open world activities into activities for relaxation and violent categories strengthened the confirmation of the hypotheses.


Pre-existing anxiety and depression symptoms influence engagement with open world activities.


Participants with self-reported elevated levels of anxiety exhibited a significant association with increased engagement in open-world gameplay activities within RDR2. Post hoc analysis revealed even more precise and significant positive correlations, splitting this engagement into activities tailored for relaxation versus those requiring violence (H2a). These results bolster the observation that individuals cope with distress by avoiding anxiety-provoking stimuli with these casual activities in video games providing an escape from this stimulus (Lewis, 2021). The finding aligns with Lewis's (2021) study on Animal Crossing during the pandemic, which found that increased activity in meaningful casual activities in the game was associated with increased anxiety symptoms during the pandemic. Since these activities have simple rules, controls, and very short-term commitments with no negative or redoing implications, people have a higher inclination towards activities like these to ward off anxiety-stimulating thoughts as also suggested by (Granic, 2014).


In tandem, participants reporting elevated levels of depression similarly demonstrated a notable inclination toward engaging in open-world, unstructured gameplay. Subsequent post hoc analysis revealed a distinct preference for activities tailored for relaxation over those involving violence (H2b). This observation suggests that players enduring prolonged sadness and guilt are also drawn to these activities to alleviate their symptoms. This engagement is directly correlated with the suppression of ruminating thinking style which is directly associated with the exacerbation of depressive thinking styles. The post hoc results suggest that calming pursuits of relaxation due to their less frustrating nature are better suited than violent actions in suppressing the said rumination thinking. These findings are directly in line with Kühn et. al’s (2018) conclusions on action video game activities reducing rumination.


Impact of open world activities engagement on mental well-being.

Those who immersed themselves more in these open-world activities reported heightened mental well-being on the WEB scale following their gaming experiences. These findings highlight the positive impact of diverse open-world activities in video games, providing players an opportunity to respite from intense narrative or action-packed gameplay, facilitating relaxation and unwinding at their own pace and convenience. These activities tailored for relaxation and challenge outside the main narrative, in which the player can partake at his own will and volition, tend to influence better mental health outcomes in the players. These relaxing activities in video games provide players with opportunities to unwind and relax and a sense of achievement. Conversely, the ease of access to real-life experiences such as fishing and horse riding compared to real life could also be a significant factor in doing so. Players can fish and ride horses with much more ease at the voice of command than having to go through much effort, uncertainty, and effort, experiencing the same in real life.


These activities intended for relaxation and unwinding appear to have significant positive effects and a pull for engagement and potential well-being benefits. Explanations from Bergman’s (2023) study suggest that players with depression who had video game intervention for six weeks showed lessened rumination thinking compared to control groups. This increased engagement in such activities could have been associated with decreased rumination thinking. These align with findings from Lewis's (2021) study on the game Animal Crossing and how socially meaningful in-game activities meant for pastime alleviate players' symptoms of worrisome and intrusive thoughts (H4). Moreover, it confirms and reassures the findings from the ESA by Kodiak (2023) about why people choose to play video games, with 63% and 52% of players attesting that it makes them feel happier and navigate difficult times.


A similar relationship was also observed, with higher engagement in open-world activities and the self-determination theory sub-scales signifying a high correlation between both measures. Players’ need for competence is constantly met as they engage in the diverse activities the game has to offer by giving optimal challenges and continuously rewarding them; activities like fishing and bounty hunting are designed to get more challenging and rewarding as the player progresses with special rewards for legendary animals and catching famous gunslingers. Moreover, players who spend more time in these activities are usually completionists satisfied with completing all activities, unlocking all locations, and achieving trophies for all the challenges. These completionists are independent and can devote themselves to long-term goals with a singular focus. Completionists perceive this engagement as competence reflecting and satisfying their desires to engage in the game's content and attain medals. This satisfaction is directly related to mental well-being as competence needs are met (H6a).


Since these open-world activities happen outside quest lines, with no narrative, honor, or other implications, players who engage more in these activities are more willing to undertake them and take high personal interest, volition, and value in them, powerfully underscoring the satisfaction of their autonomy needs. Autonomy differs between games, and open-world games are known to provide higher degrees of autonomy than any other game (Hughes, 2023). This explains a deep-seated satisfaction of autonomy needs, reflecting a sense of agency, volition, and freedom to pick up any activity in the RDR2’s game world(H6b).



Relatedness needs satisfaction, which occurs when players feel a sense of connection with NPCs or a sense of belonging in the game world. Players meet this need with immersion and belonging while engaging in open-world activities in RDR2 fishing, hunting, riding, etc. Moreover, playing tabletop games with NPCs reinforces virtual friendships, bounty hunting, and other violent activities underscore the need for connection, satisfying the need for relatedness both by rooting for and against the players equally (H6c). These interactions and activities, although digital, evoke similar rewards and emotions in the game as someone would in real life doing the same activities. Aligning with Grasse et al.'s (2022) definition of relatedness in role-playing games is the capacity to experience the world from another’s perspective and the activities in RDR2 being as close to real life, this increased engagement in activities promotes relaxation and increased relatedness deriving similar positive rewards outside the game world. This could also be the case since players can choose the activities they relate to from their plethora of options, which also tends to satisfy the needs for relatedness. 

Limitations and Future Research

The study’s reliance on participants recalling their mental states during initial gameplay, in-game actions, and post-game experiences introduces recall bias. 35% of the respondents had played in the first six months of the game, while only 11% had played in the recent six months of the study. This could have influenced the study’s findings. Future research could explore upcoming game titles and systems for well-being effects before release to address this limitation. Pre-release studies assessing participants' mental states and post-release analyses based on in-game engagement could enhance the directionality and eliminate bias.

The original 5-point Likert scales of GAD-7, GDS, WEMWBS, and BPNS questionnaires were adjusted to 7 points to provide a detailed understanding of the data. This adjustment compromised the psychometric validity, necessitating manual categorization. Future research should consider measures on a higher-point Likert scale by default and maintain psychometric validity. The GDS measure to measure depression levels is meant for the older population. It was chosen over the PHQ-9 due to its simplicity and ease of recall as a human choice. While the GDS scale has been validated for younger age groups by Guerin et al. (2018), showing decent sensitivity across all age groups, the study is still limited. Future research should consider the target audience for the game and choose appropriate scales suited for the demographic.

The survey responses were highly inclined towards a high-honor playstyle, raising the possibility of social desirability bias or genuine enthusiasm for the game. Spokes and Denham (2019) highlight that requesting participants to self-report based on recollection triggers social desirability bias, wherein individuals adjust their responses to align with perceived social expectations. Most survey participants were sourced from Red Dead subreddits, which attract ardent fans. Inferring that these participants might be inclined towards a high-honor playstyle for the best narrative experience, limiting the generalizability of the findings beyond this fanbase. Inquiring about participants' perceptions of the game's elements and their impact on mental well-being showed an anomaly. 88% of respondents have played for over 40 hours and strongly agreed with the questions, hinting at potential bias in the dataset. Suggesting that the positive responses only partially captured a set range of player experiences and opinions, emphasizing the need for more varied participant recruitment strategies for future research.

This study exclusively engages with honor systems and open-world activities of one game. Future research can build on this foundation by extending the analysis to other role-playing games with extensive activities that measure honor systems with reward/punishment dynamics, such as Fable, Skyrim, or the Mass Effect series. Additionally, exploring how individual differences in personality, cultural background, and gender influence these systems could further our understanding.


In conclusion, video games serve as a steadfast pastime for individuals to unwind, relax, and escape from the stressors of real life. A substantial portion of the player base acknowledges that video games help alleviate stress and navigate challenging periods. RPGs grant autonomy to players to choose their playstyles with no real-life repercussions, significant enjoyment, or well-being benefits from displaying either prosocial or antisocial playstyles. As found in this thesis, prosocial behavior has a significant positive impact on individuals undergoing depression symptoms, highlighting the therapeutic potential of such honor-based game systems. RDR2 exemplifies effective feedback with positive audio and NPC cues and sustains players with varied narrative complications based on their actions. While it is laborious and resource-intensive to implement multiple narrative paths and acting complexities, future game developers who design systems based on player actions should feel responsible for imbibing these intricacies in feedback systems to enable positive real-world outcomes for players, as demonstrated in this study’s results for depressive symptoms. Following the footsteps of RDR2 provides a solid foundation to build and sustain player goodwill from their prosocial behavior through immediate, intermediate, and prolonged narrative rewards as a roadmap to help players.

Active engagement in unstructured open-world activities tailored for relaxation, a pastime that the player can seek themselves, significantly influences well-being and helps people during challenging times. As found in this thesis, the more such activities for relaxation, the more positive impact players have reported in improved well-being and was shown to have positive correlations with anxiety and depression symptoms alike. Open-world game developers should incorporate calming pursuits, be it many mini-games or activities mimicking real-life activities like fishing and riding, which are meant for an enriching experience in real life, into video games to impact players’ well-being.


This paper's primary author and researcher would like to thank their thesis advisors, Dr. Elizabeth Stringer and Mario Rodriguez at Southern Methodist University Guildhall, for their support, guidance, and direction throughout the research and writing timelines. Furthermore, they would also like to thank their colleagues and fellow Production master students Reed Devany, Alejandro Ramirez, and Jianwen Gao for their suggestions and advice.


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